危急的COVID-19肺炎的人类遗传和免疫学决定因素
Qian Zhang1,2,3, Paul Bastard4,5,6,7,
1St Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA. qzhang02@rockefeller.edu.
影响I型干扰素 (IFN) 的遗传和自身免疫因素至少解释了15%的严重COVID-19肺炎病例. 呼吸道I型IFN免疫力不足可能导致严重的疾病,受年龄和性别的影响.
科学领域:
- 免疫学
- 病毒学
- 遗传学
背景情况:
- SARS-CoV-2 感染通常是轻微的,但10%的患者患有低血压性肺炎,3%的患者病情危急.
- 死亡风险随着年龄的增长而增加,男性的死亡风险更高.
研究的目的:
- 审查决定严重COVID-19肺炎的分子和细胞因素.
- 确定严重的SARS-CoV-2的遗传和自身免疫原因.
- 了解I型干扰素 (IFN) 在COVID-19发病过程中的作用.
主要方法:
- 对关键COVID-19肺炎的分子和细胞决定因素的现有文献的审查.
- 在危急的COVID-19患者中对I型IFN的先天性错误和自身抗体的患病率的分析.
主要成果:
- 在60岁以下的重症肺炎患者中发现的I型IFN (TLR3,TLR7缺陷) 的先天性错误.
- 在70岁以上的重症肺炎患者中发现了中和I型IFN的自身抗体 (IFNα,IFNβ,IFNω).
- 至少15%的严重COVID-19肺炎病例是由这些IFN相关的免疫缺陷解释的.
结论:
- 第一种类型的IFN免疫力,特别是TLR3/TLR7依赖性免疫力,对于对抗SARS-CoV-2的主体免疫力至关重要.
- 在感染初期缺乏I型IFN免疫力可能导致病毒传播和严重的炎症.
- 年龄和性别影响这些免疫缺陷的流行和影响.
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